Chairman Mao is famous for his saying, “Defy the enemy strategically, pay attention to the enemy tactically”. It is very suitable for the prevention and treatment of chronic atrophic gastritis and precancerous gastric lesions. Patients suffering from chronic atrophic gastritis and gastric precancerous lesions should, on the one hand, actively treat and pay attention to life conditioning, follow up and monitor regularly according to doctors’ orders, so to speak; on the other hand, they should also pay attention to eliminating the psychological fear of cancer, relaxing their mindset, improving their confidence in overcoming the disease and avoiding the influence of bad mindset on the disease, so to speak, strategically, they should defy.
Basics
1.What is chronic atrophic gastritis? What is precancerous lesion of stomach?
In the hospital we will see many patients with atrophic gastritis, many patients think that atrophy is the volume of the stomach has become smaller, atrophy, continue to develop, the volume of the stomach is getting smaller and smaller, will affect eating. In fact, this is not the case. The “atrophy” of chronic atrophic gastritis is the atrophy of the gastric acid-secreting glands in the gastric mucosa, not a reduction in the size of the stomach. The “atrophy” of chronic atrophic gastritis is the atrophy of the gastric mucosa glands that secrete gastric acid, not a reduction in the size of the stomach. In China, most patients with atrophic gastritis have atrophy in the gastric sinus, and the atrophy is focal, so it does not have much effect on the overall acid secretion. Therefore, many patients do not show signs of insufficient gastric acid secretion, and some even show signs of excessive acid secretion such as acid reflux and heartburn.
Some patients with chronic atrophic gastritis are diagnosed with “enterosis” and “heterogeneous hyperplasia” during a gastroscopic histological examination. Enterosis is short for “intestinal epithelial metaplasia”, which is caused by certain pathogenic factors that make the mucosa of the stomach appear similar to that of the intestine; heterogeneous hyperplasia is when the growth of cells deviates from the normal growth pattern and track and appears abnormal. In short, both of these manifestations are abnormalities in the structure of the gastric mucosa.
2.Why should we pay attention to the research of gastric precancerous lesions in chronic atrophic gastritis?
Stomach cancer is one of the malignant tumors with the highest incidence worldwide. In China, gastric cancer is the third most common malignant tumor tumor. Scientists have found that the majority of gastric cancers in our country develop through several steps such as atrophy, intestinalization, and heterogeneous hyperplasia. Therefore, atrophic gastritis is considered to be a kind of pre-cancerous disease of the stomach, and intestinalization and heterotypic hyperplasia that occur on the basis of atrophy are called precancerous lesions of the stomach. Regardless of atrophy or intestinalization and heterogeneous hyperplasia, the chance of developing gastric cancer will be more than normal. Among them, heterogeneous hyperplasia is the last step before the occurrence of gastric cancer and is the most important gastric precancerous lesion, therefore, it should be paid more close attention.
Strategy chapter
”Strategic defiance” is not to ignore chronic atrophic gastritis gastric precancerous lesions and let them go. We have seen many patients suffering from chronic atrophic gastritis and gastric cancer lesions in hospitals. Once they learn that the disease they are suffering from is a precancerous disease of the stomach, coupled with the over-exaggerated danger of cancer by some doctors and inappropriate propaganda by some media, they have a very serious cancer-phobic mentality and are worried all day long. Under the influence of this bad psychological state, patients’ indigestion symptoms such as stomach pain, bloating and fullness are likely to recur, which seriously affects patients’ quality of life and is not conducive to disease treatment. In fact, scientists have found after long-term research that although patients suffering from atrophic gastritis, with intestinalization and heterogeneous hyperplasia have a higher risk of developing gastric cancer than normal people, in general, very few of them actually develop gastric cancer in the end. Moreover, early treatment may block the transformation and progression of the disease to cancer. Therefore, we suggest that patients suffering from atrophic gastritis and intestinalization and heterogeneous hyperplasia need not worry too much, but should maintain a good attitude, build up confidence to overcome the disease and actively treat and recuperate, so that the disease can develop in a good direction. “Strategic defiance” is in fact another sense of importance, is to lift the burden of thought and positive and optimistic mindset.
Tactics
Tactically, patients with atrophic gastritis and precancerous gastric lesions should combine the three aspects of treatment, recuperation and monitoring.
1.Treatment
For the treatment of atrophic gastritis and its precancerous lesions, modern medicine still lacks ideal methods and means so far, and mainly deals with symptomatic treatment. We have accumulated valuable experience by participating in the national “Eighth Five-Year Plan” research project on gastric precancerous lesions. We have achieved good results in the treatment of precancerous lesions by using TCM compound prescriptions to help eliminate the evil and improve the atrophy of mucosal glands through holistic dialectic of TCM combined with the mucosal condition under gastroscopy and biopsy pathology. TCM treatment for this disease can be done in two ways: tonics and proprietary Chinese medicine treatment. TCM is an individualized treatment, which can achieve better results by combining the prescription of drugs with the patient’s physical condition, symptoms, submucosal manifestations and biopsy pathology; proprietary Chinese medicine is convenient to take, but compared to traditional Chinese medicine, a proprietary Chinese medicine is generally only effective for a certain type of atrophic gastritis, and slightly less effective for other types. Therefore, we suggest that patients should still take tonics as much as possible, and if they encounter inconveniences such as the need to travel, they can take pCms for a short period of time under the guidance of a doctor. Regardless of whether it is soup or Chinese medicine, patients with atrophic gastritis and gastric precancerous lesions should establish the belief of fighting a long-lasting battle. It takes 3-5 months for the reconstruction of normal glands, and 3-6 months or even longer courses of medication are needed to reverse precancerous lesions. In addition, for patients with atrophic gastritis, poultices are also a good choice, but they need to be taken under the guidance of a doctor, which can improve the physical condition, strengthen the body and dispel the disease to prolong the life.
2, conditioning
As the saying goes, chronic gastric disease is three parts treatment and seven parts nourishment, for patients with atrophic gastritis, in active and timely correct treatment at the same time, good daily regimen is also very important. Scientists have found through research that poor diet and living habits can increase the risk of stomach cancer. Smoking, drinking alcohol, lack of fresh vegetables and fruits in daily diet, frequent consumption of moldy, pickled, smoked and fried foods, high salt diet and eating too hot diet are all factors that can increase the risk of stomach cancer. Therefore, patients with atrophic gastritis and precancerous gastric lesions should pay attention to the following three points.
(1) not to smoke and drink less alcohol.
(2) Develop good dietary habits: eat regularly and quantitatively, chew slowly, eat a low-salt diet, do not overeat, and do not consume overheated food.
(3) Increase fresh vegetables and fruits in the diet, eat less or no pickled, smoked or fried foods, and no moldy foods.
3.Monitoring
Regular gastroscopy and pathological examination is a very important part of gastric precancer prevention and treatment tactics. Patients should monitor their conditions regularly under the guidance of doctors, only in this way can early gastric cancer be detected and treated early to improve the survival rate of gastric cancer patients. Patients with precancerous gastric lesions can self-supervise follow-up according to the following principles: patients with atrophic gastritis without intestinal epithelial hyperplasia and heterogeneous hyperplasia in pathological examination can have gastroscopy and pathological examination every 1-2 years; patients with atrophic gastritis with moderate or severe atrophy or intestinal epithelial hyperplasia in pathological examination can follow up every year or so; patients with mild heterogeneous hyperplasia found in gastroscopy should have gastroscopy and pathological examination again in about 6 months. Gastroscopy and pathological examination should be done once again. Patients with severe heterogeneous hyperplasia should have their gastroscopy and pathology reviewed immediately, and according to the physician’s guidance can choose surgical treatment or local treatment under gastroscopy.